NPIMap

Organization Active NPI

Hy-Vee Inc

  • Community/Retail Pharmacy
  • Sioux City, IA
National Provider Identifier
1063448587
Registry record updated Apr 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
1050 Issued in IA
Legal business name
HY-VEE INC
Practice address
3301 Gordon Dr
Sioux City, IA 51105-3708
Phone
(712) 234-1949
Fax
(712) 255-8087
NPI assigned
Jun 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Angie Nelson
Title
Senior Vice President
Phone
(515) 267-2800

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 1050 IA
Community/Retail Pharmacy 3336C0003X 1050 IA Primary

Addresses

Primary practice location

3301 Gordon Dr
Sioux City, IA 51105-3708

Mailing address

PO Box 850442
Minneapolis, MN 55485-0442
Phone (515) 267-2800

Other identifiers 3

IdentifierTypeStateIssuer
176255MedicaidIA
8531840MedicaidSD
1619189OtherIANCPDP

Other names 1

  • Hy-Vee Pharmacy #3 (1615) Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031230000598 IA Part B Supplier - Mass Immunization (Roster Biller Only) 7416855242 This NPI is an additional NPI on the enrollment
Practice locations: Albia, IA
O20100930057594 IA DME Supplier - PharmacyDME Supplier - Grocery Store 7416855242 Practice locations: Sioux City, IA

National Provider Directory

National Provider Directory
Tax ID family
Drug Town 7060278 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 22

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 22

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682380800000",
    "number": "1063448587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 850442",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554850442",
            "telephone_number": "515-267-2800",
            "fax_number": "515-559-2593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 GORDON DR",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511053708",
            "telephone_number": "712-234-1949",
            "fax_number": "712-255-8087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HY-VEE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-25",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "515-267-2800"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IA",
            "license": "1050",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IA",
            "license": "1050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176255",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8531840",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "1619189",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hy-Vee Pharmacy #3 (1615)",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hy-Vee Pharmacy #3 (1615)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sioux City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.